Faculty Bibliography

INTRODUCTION/UNASSIGNED:Although platelet-rich plasma (PRP) is a widely used treatment for androgenetic alopecia (AGA), the impact of patient age on treatment efficacy remains underexplored. METHOD/UNASSIGNED:This retrospective study evaluated PRP outcomes in 57 AGA patients treated at NYU Langone Health, stratified into four age cohorts. Changes in trichometric hair density and width were measured from initial to final follow-up visits. Statistical significance and linear regression testing were determined using ANOVA and Rank-Based ANCOVA, respectively. RESULTS/UNASSIGNED:While overall changes in density and width did not differ significantly across age groups, younger patients trended toward greater density gains. Furthermore, greater baseline hair width was predictive of smaller improvements in width, and significant interactions between age and the number of PRP sessions suggested that older individuals may require a greater number of treatments to attain results comparable to those seen in younger cohorts. Additionally, improvements in hair density were positively associated with the number of adjunctive therapies, as patients who received more concurrent treatments experienced greater gains. PRP was well tolerated across all age groups. CONCLUSION/UNASSIGNED:These findings highlight the potential impact of patient age on PRP efficacy, informing counseling and treatment planning.

BACKGROUND:Ritlecitinib, an oral JAK3/TEC family kinase inhibitor, demonstrated efficacy over 48 weeks in patients with alopecia areata (AA) in the ALLEGRO phase 2b/3 study. OBJECTIVES/OBJECTIVE:This post hoc analysis evaluated individual Severity of Alopecia Tool (SALT) score trajectories in patients who received ritlecitinib 50 mg and rolled over from Phase 2b/3 into the ongoing, open-label, Phase 3 ALLEGRO-LT study to describe long-term response patterns and associated baseline disease characteristics. METHODS:Patients aged ≥12 years with ≥50% scalp hair loss received ritlecitinib 50 mg once daily in both studies. SALT score trajectories from baseline to Month 24 were used to categorise patients as early (SALT score ≤20 at Week 24 and Months 12 and 24), middle (≤20 at Months 12 and 24) or late responders (≤20 by Month 24) or as partial responders (maintained 30% improvement), relapsers (achieved but did not maintain 30% improvement) or non-responders (did not achieve 30% improvement). The proportions of patients achieving sustained response (achieved and maintained SALT score ≤20 at all subsequent available time points through Month 24) and complete response (SALT score 0 at ≥1 time point through Month 24) were evaluated. Multivariable logistic regression assessed variables associated with response. RESULTS:Of 191 patients treated with ritlecitinib 50 mg, 87 (45.5%) were responders (SALT score ≤20), 24 (12.6%) were partial responders, 24 (12.6%) were relapsers and 56 (29.3%) were non-responders. Of 87 patients categorised as responders, 81 (93.1%) sustained their clinical response and 47 (46.0%) achieved complete response. Factors associated with treatment response included female sex and less extensive and shorter duration of hair loss. CONCLUSIONS:Approximately 45% of patients were SALT score responders, with up to 11% requiring >1 year of ritlecitinib treatment to achieve response, highlighting the importance of extended treatment duration. GOV REGISTRATION/UNASSIGNED:ALLEGRO phase 2b/3 study (NCT03732807); ALLEGRO-LT study (NCT04006457).

Monitoring both subjective and objective responses to alopecia treatment is critical for assessing patient perception and therapeutic efficacy. Platelet-rich plasma (PRP) therapy is a widely used treatment for alopecia, particularly androgenetic alopecia (AGA), yet the correlation between patient-reported outcomes and trichometric measurements remains poorly defined. This retrospective study analyzed data from 56 alopecia patients treated with PRP at NYU Langone Health between November 2017 and March 2025. Patients were categorized as "improved," "stable," or "worse" based on self-assessments, and changes in hair density and width were evaluated over the course of PRP treatment. Spearman's rank correlation and Kruskal-Wallis Rank Sum Tests were used for statistical analysis. Results showed that patient-reported outcomes correlated significantly with changes in hair density (p = 0.0006), but not hair width (p = 0.2688). The greatest increase in hair density was observed in the "improved" group (+ 18.9 hairs/cm²), with a more modest gain in the "stable" group (+ 7.6 hairs/cm²), while the "worse" group experienced a decrease (- 19.7 hairs/cm²). Differences in density across all three groups were statistically significant (p = 0.0012), whereas width changes were not (p = 0.5009). Subgroup analysis of AGA patients yielded similar findings. These results suggest that patient perception aligns more closely with density changes than width changes. Combining subjective assessments with objective measurements enhances clinical decision-making, expectation management, and holistic evaluation of PRP treatment efficacy in alopecia patients.

Premature hair graying (PHG) is the early loss of natural hair color, influenced by genetic, biological, and environmental factors. This review discusses the significant psychological impacts of PHG and explores its underlying mechanisms, related health conditions, and available treatments. The review examines the roles of genetics, oxidative stress, and lifestyle factors such as smoking and diet in premature graying. It also considers associated medical conditions and current and emerging treatment options. This overview aims to improve understanding of PHG and its broader implications.